Eligibility Coordinator

NOTE: THIS POSITION HAS THE ABILITY TO WORK REMOTE UNTIL FURTHER NOTICE!

The current healthcare landscape is ever-changing, but the desire to provide patients with better, more affordable care is consistent. Healthcare providers are working to evolve and support population health management and today’s value models, but there is still uncertainty in the market. Providers need a proven, integrated approach that takes the best of today’s technology and matches it with deeply experienced professionals.

Innovista Health Solutions is an Illinois-based service organization with management services operations in Illinois and Texas. We are currently looking for an Eligibility Coordinator in our Oak Brook, IL office. At Innovista, we believe that positive forward movement in today’s uncertain healthcare market stems from the combination of innovative programs and dedicated people. Join the Innovista team and lead the charge to a better, more efficient healthcare system.

JOB SUMMARY:
The Eligibility Coordinator organizes, maintains, and updates eligibility information. Uses proprietary company software (EZ Cap, EZ Net, and Eligibility Manager) to maintain the integrity of the member database regarding eligibility. Provides general support to other departments as they relate to eligibility issues.

DUTIES AND RESPONSIBILITIES:

• Download and maintain eligibility data from health plans using websites, discs, and ftp
• Enroll and update member records based on the weekly/monthly database file
• Interact with Customer Service Department staff to resolve complaints related to eligibility.
• Interact with the Customer Service Department staff to verify member eligibility
• Investigate and research complex eligibility issues to facilitate a resolution
• Provide data management and data entry to ensure the database is readily usable to support the activities of other working groups
• Perform testing of system updates prior to implementation to ensure accuracy and facilitate an efficient transition to production
• Keep supervisor apprised of all system and client issues
• Provide support to other working areas as needed
• Communicate and interact effectively and professionally with co-workers, management, customers, etc.
• Comply with HIPAA, Diversity Principles, Corporate Integrity, Compliance Program policies and other applicable corporate and departmental policies.
• Maintain complete confidentiality of company business.
• Perform other duties as assigned

• Associate degree or equivalent experience required.
• At least 2-3 years of relevant professional experience.
• Working knowledge of healthcare eligibility, capitation and/or commercial HMO experience a plus.
• Knowledge of HIPAA, state and federal guidelines on privacy, transactions and security.
• Demonstrate excellent organizational skills.
• Demonstrate effective verbal and written communication skills.
• Demonstrate analytic skills when problem solving.
• Proficient in MS Office Applications and ability to learn department and job specific software systems.
• Demonstrate high attention to detail and a high degree of accuracy
• Able to commit to Innovista’s corporate mission and values
• Able to switch priorities in a positive and effective manner when directed by Company leadership.
• Able to effectively communicate technical concepts with team members and basic business concepts with team members and internal customers.
• Eligible for consideration of partial work from home status upon completion of probationary period as designated by the direct supervisor.

BENEFITS:

Innovista is dedicated to hiring passionate individuals who embody our core values: integrity, determination, and teamwork. We recognize the importance of work-life integration and seek to provide our employees with competitive benefits, which include:

• Comprehensive health plan options, dental, and vision coverage subsidized by Innovista
• Opportunity to work from home, based on position and manager discretion
• Company-paid benefits, such as short- and long-term disability, employee life, and AD&D
• Discretionary bonus
• 401(k) with company match
• Opportunity for career advancement and growth
• Flex time options may be available

We do not post salary ranges. Salary ranges posted on other sites are not tied to our labor market specifications and are not relevant.